Challenges in Digitizing Informed Consents, and How to Overcome Them

A well-respected CIO I know once referred to Informed Consents as “the last mile to a paperless patient record”. Given that over 76% of Informed Consents are still handled on paper, it appears the majority of health systems have not crossed the finish line.

The case for moving away from paper is strong; The Joint Commission cites over 500 organizations each year for failing to have proof of completed, compliant consents prior to the procedures performed. Lack of a verifiable, time-stamped consent can be used in lawsuits related to malpractice tied to a procedure.

Many health systems have processes to confirm a valid consent prior to the beginning of an operation. Failure to find this consent right away leads to delays in surgeries which cost $62 per minute according to a 2022 article found in the National Library of Medicine. A study by JAMA showed $265,112 in revenue on average is lost annually in a 500-bed hospital due to consent delays a year in lost surgical revenue.

Paper creates pronounced problems with compliance and risk, and the impact on revenue is also high, so why are we still seeing so many consents completed on paper?

After 7 years of supporting clients with Informed Consenting, we at Interlace Health have come to understand why organizations have tried and failed to digitize the process and why some organizations have chosen not to embark on this transformation.

Here are 4 common challenges we’ve uncovered:

1. Converting paper consents into digital formats can be a lot of work, especially if you are creating the consent forms within the Epic EHR. If you consider all the Informed Consents needed by all your service lines, it can number in the hundreds. Creating the digital version including all the consenting language for all these consents can take months to do internally and be very expensive if you use Epic certified consultants.
2. Consents need to be updated over time due to changes in regulations as well as your own organization’s requirements. Revisiting each of these digital consents to get them up to date again requires your staff or expensive third-party consultants’ time and attention. Who on your team will be keeping tabs on changing consenting language required in your state?
3. Different consents have different workflow requirements. We’ve worked with health systems that require an Imaging procedural consent to be stored in both the non-Epic PACS systems as well as the Epic EHR. An anesthesiologist’s consent might need to be stored in 2 separate EHRs, one of which is often not Epic. If you are looking to support Clinical Trial Consenting, the FDA has a set of unique requirements that Epic consenting currently does not support. Some providers start informed consent in the clinic weeks before a surgery is even scheduled, while others need to get them signed at the pre-op bedside for emergency procedures. How does your health system handle and manage all these different workflow needs?
4. Another challenge comes when a surgeon outside of your system has operating privileges. Both the doctor and patient often prefer to handle the consenting process during the pre-operation consultation. These consultations often take place in the doctor’s office, and with the current process, those signed consents do not always make their way to the hospital for the hospital team to scan into the patient’s chart day of surgery.  If you don’t enable the physician’s office to send the consent digitally and allow it to be assigned to the patient hospital record, it ends up needing to get re-signed on the day of surgery; redundant work for the care team and the pre-occupied patient

We also understand that change is hard. Even if paper is suboptimal, it may be the workflow your team is comfortable preforming. Maybe you have tried implementing eConsents and it didn’t stick. The medical team has enough to concentrate on ensuring optimal patient care. They don’t want to deal with another mobile device just to get a formed sign. They would rather go back to paper, but what does that do for your compliance and HIM team?

Interlace Health has seen hospitals struggle with these paper-based workflows over the last 32 years and listened to their evolving needs. We use this feedback from the field to continually develop our eConsenting offerings and combat these challenges.

Our Informed Consent solution includes the ability to have consents stored in multiple locations. We allow for the transfer of consents not only within a health system but can import consent forms sent from other healthcare providers via email or fax. Our solution has the flexibility to support all your care settings and service lines even those challenging Clinical Trial Consents.

Because we designed our software from the ground up to optimize the consenting process, we can digitize your consents more rapidly than other systems including Epic Consents. Our Services team includes a group of forms experts who can design, integrate, and update consents more rapidly and at a lower cost than your staff or consultants. We can even track changes in mandated consents such as the Texas Surgical Consent language requirements.

Our implementation team knows how to create the right workflows for each consent to ensure a better experience for patients, nurses and doctors than alternatives.  We also provide guidance on the right type of devices that are ergonomically acceptable for patients and staff yet still allow everyone to “see what they are signing” to maintain compliance.

 

Ready to efficiently and effectively upgrade from paper to electronic consenting within your Epic EHR?  Let’s schedule time to discuss your unique requirements and how Interlace Health can make this work for you.

 

About the Author:

Art Nicholas, Chief Commercial Officer at Interlace Health, has over 20 years of experience in launching and expanding technologies in the healthcare field. He was a pioneer in getting speech recognition used by both doctors and nurses in inpatient and outpatient settings. In every role, his teams have successfully implemented automated workflows which benefit patients, providers and the healthcare ecosystem. A strong believer in the healthcare IT community, he has been an active member of CHIME, HIMSS, and MUSE, sitting on a number of their committees. He is committed to improving the quality of patient care and lowering the cost of care delivery through well-designed and well-supported technology workflow solutions. Follow Art on LinkedIn.

 

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